What Are Statin Drugs?

The first statin drug, mevastatin, was isolated from a fungus. Red yeast rice contains mevastatin, although different batches of this natural product contain different amounts of mevastatin.

Several other statin drugs were derived from this fungal compound. Others are fully synthetic. All of them block an enzyme the body needs to create cholesterol. This lowers the amount of bad LDL cholesterol in the body.

Are Statin Drugs Too Risky?

"If you have heart disease, or are at very high risk of heart disease with high cholesterol, statins are one of the best classes of drugs we ever had," Nissen says. "When used thoughtfully and with good monitoring, they are safe and effective."

"Some people are running around saying we should put statins in the water supply, and that is wrong. These are serious drugs," Nissen says. "Statins should be coupled with good diet and exercise. They are not a substitute for a healthy lifestyle."

Who Should Take Statin Drugs?

Risk is defined by your age, your total cholesterol level, your good HDL cholesterol level, your blood pressure, and whether you are a smoker. Your blood level of C-reactive protein (CRP) and whether either of your parents had an early heart attack also are factors.

But the decision on whether or not to take a statin drug should be made in consultation with your doctor, who can take all your individual risk factors into account.

Statin drugs are not a cure-all. They should be used only along with proper exercise and a healthy diet.

And some people definitely should not take statins. Pregnant women, or women of childbearing age not using contraception, should not take statin drugs. And certain other drugs can have dangerous interactions with statins.

Media reports of these risks alarmed many statin users. The Cleveland Clinic's Nissen says these risks are real, but not particularly worrisome.

The increase in blood sugar, he says, is small. But in people with already high blood sugar, this small increase may push them across the threshold of a diabetes diagnosis.

"It turns out that analyses of controlled trials show that those who cross the threshold into diabetes had exactly the same benefits of the statin," Nissen says. "So in terms of risk vs. benefit, there is no change."

A more common risk seen with statins is muscle tenderness, which occurs in some 5% of patients. This can be extremely severe.

"A doctor should suspect a statin side effect in any patient who complains of muscle pain," Nissen says. "They can often switch to another statin. We can usually find a statin drug people can tolerate without too much difficulty."

There are several risk factors for muscle side effects linked to statins: